In this week’s podcast, we discuss the evolution of the process of client choice. What started as an acknowledgement that clients/patients deserve information about their care has transformed over time into a model that acknowledges the autonomous decision making capacity of clients in partnership with information and support offered by the care provider. Respecting this client autonomy is an essential element of ethical practice.

This framework, called Shared Decision Making, is one that takes a little time and practice to become fluent in using. We use a framework from the University of Ottawa/Ottawa Hospital Research Institute (be sure check out their website for a variety of resources including a tutorial). It starts with an evaluation of options, and the risks/benefits/pros/cons of each of those choices. The midwife’s role in this part is especially important, as they can provide references and resources, which is valuable in helping the client navigating the sea of information overload. The client then considers their own values to weigh which risks/benefits/pros/cons are more or less in alignment with those personal values. They then identify their needs–for more knowledge, support, or assistance–and proceed to making a decision for themselves.

We have created a Shared Decision Making template for you to use. This is meant to assist clients in wading through the overwhelming number of choices and decisions they must make, and midwives in providing high-quality, evidence-based care.

You can find Metro Midwifery’s two-page Shared Decision Making Tool here.

We hope you enjoy this week’s podcast!